This document discusses self-medication and the dangers of abusing prescription drugs. It contains the following key points: 1. Self-medication involves taking medications without a prescription due to various social, economic and cultural factors. 2. Dependence and addiction can occur when prescription drugs are overused, leading to negative health and social consequences. 3. A case report describes a patient who used cocaine to self-medicate migraines but later developed a full addiction, showing how self-medication can escalate into substance abuse.

1. UNIVERSIAD NACIONAL PEDRO RUIZ GALLO
FACULTAD MEDICINA HUMANA
MEDICAL ENGLISH
AUTOMEDICATION
DRA. ROSA
2011

2. MEDICAL ENGLISH 2011
INTEGRANTS
 CARUAJULCA SALDAÑA MELISSA ELSI
 CHAFLOQUE CARHUAS JANE LADY
 CHAMBERGO RUIZ GUILLANA DEL FÁTIMA
 CHAPOÑAN TERRONES MIGUEL ÁNGEL
 RIVERA PAICO MAIRA LEONOR
 ROJAS RUIZ ROMMEL ADOLFO
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1.-Introduccion
ACULTAD MEDICINA HUMANA
FACULTAD MEDICINA HUMANA
Self-medication is a type of conduct that involves taking medications as the
patient's own initiative, on the advice of the pharmacist or health of any person.
There are many factors that influence this type of behavior, emphasizing social
factors like peer pressure or our own families that we offer an alternative to solving
our health problems based on their own experience. It also influences the low level
of education of people especially the parents, which completely ignore the risk
involved in self-medication.
Among the economic factors that influence self-medication include
unemployment, poor working conditions and living standards of most people and
especially the low income family that gives them access to health services which
translates lack of prescription by a trained professional.
Among the cultural factors influencing the lack of access and limited availability of
information allowing pharmaceutical companies to disseminate biased
information that encourages people to consume drugs supposedly very safe, this
also is coupled with poor health education with which have.
2.- Definition
Self-medication is the act by which we medicate ourselves with no prescription,
which some drugs lead to dependence and
therefore the mass consumption of them
.
Self-medication with drugs that alter mood,
usually respond to adaptive behavior, as an
attempt to escape boredom, loneliness,
stress, frustration.
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3.-Self-Medication as an Explanation for Addiction
Dependence occurs when there is an overuse of the substance that produces
significant negative consequences over an extended period of time.
Dependency, called dependency syndrome in the latest edition of the
classification of diseases, ICD-10 (WHO, 1992), is defined as "a set of physiological
manifestations, behavioral and cognitive in which drug use or a type of them,
takes the highest priority for the individual, even bigger than any other type of
behavior in the past had the highest value ...".
Its causes are searching for people to reduce pain and anxiety but what is
generated is increased tolerance or need for increasing amounts of drug
addiction to get the desired effect, failure to attempt to stop drug addiction, and
a weakening of their social activities.
The negative consequences associated with drug addiction affect many different
aspects of a person's life. These consequences are diverse, but we can divide
them into two groups.
Health
Drug addiction causes or is involved in the emergence of diseases, damages and
organic and psychological problems. Hepatitis, cirrhosis, depression, psychosis,
paranoia are some of the disorders that drug addiction causes and can be fatal.
Social
When starting the drug addiction, the person is no longer able to maintain stable
relationships and can destroy family relationships and warm atmosphere. Drug
addiction can cause people to stop participating in the world, abandoning goals
and your life revolves around drug addiction destroying your surroundings.
Also affected the people around the adictoadiccion to drugs, especially those in
their immediate environment, such as family and friends.
Poor performance at work or in the studio
It reaches the level of goals and plans to leave,
using drug addiction as the only "solution".
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Economic consequences
Use of drug addiction can be very expensive, leading to addiction to devote all its
resources to maintain consumption, even steal the wealth of his family and friends.
Currently there are treatments that can overcome the problem of drug addiction.
Continue reading the next section to learn how to overcome drug addiction.
4.- Dangers of self Medications
Some people mistakenly believe that prescription
medications are more powerful because it is
necessary to have a prescription to buy. But it is
also possible to abuse or become addicted to
drugs to be sold freely,without prescription.
For example, dextromethorphan (DXM) is present
in some over-the-counter cough medicines.
When you take the recommended amount of
tablespoons or tablets, there is no problem. But
the high doses can cause problems in the senses(
above all in the eye and ear) confusion, stomach
pain, numbness, and even hallucinations.
5.- Whats drugs are abused more?
Medicines from prescription that are abused more often are classified into three
categories:
1.- Opioids
Examples: oxycodone (OxyContin), hydrocodone
(Vicodin) and meperidine (Demerol).
Medical uses: opioids used as painkillers (to treat pain) or
to relieve cough or diarrhea.
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How they work: opioids bind to opioid receptors in the central nervous system
(brain and spinal cord), which led to the brain does not receive pain messages.
2. Central nervous system (CNS) depressants
Examples: sodium pentobarbital (Nembutal), diazepam (Valium) and alprazolam
(Xanax).
Medical uses: CNS depressants are used to treat anxiety, tension, panic attacks
and sleep disorders.
How they work: CNS depressants slow down brain activity by increasing the activity
of a neurotransmitter called GABA. As a result, achieved a drowsy or calming
effect.
3.- Stimulants
Examples: methylphenidate (Ritalin), amphetamine/dextroamphetamine
(Adderall).
Medical uses: stimulants can be used to treat narcolepsy and ADHD.
How they work: stimulants increase brain activity, which leads to a higher State of
alert and higher levels of attention and energy.
5.- Whats are dangers of abusing drugs?
Regardless of that consume illegal drugs or
medications, abusers of these substances
tend to have problems at school, at home,
with friends or with the law. The chances that
a person commits a crime, is the victim of a
crime or have an accident are greater when
abused those substances, no matter to be of
medications or drugs.
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As well as the consumption of illegal drugs, the use of prescription drugs on
prescription for purposes different from those who have been prescribed is
associated with serious health risks.
The abuse of opioids can cause vomiting, mood changes, reduction in the
capacity of thinking (cognitive function) and even decreased respiratory function,
coma or death. This risk is greater when prescription drugs such as opioids are
mixed with other substances such as alcohol, antihistamines, and CNS depressants.
CNS depressants also have their risks. If it reduces or interrupts its use too fast,
seizures occur. Take depressants of the central nervous system with other drugs
such as analgesics of prescription, some prescription drugs without a prescription
for allergy and cold, or alcohol can slow the heart rate and respiration of a person,
being able to get to cause death.
The abuse of stimulants (such as some medications for ADHD) can lead to heart
failure or seizures. These risks increase when stimulants are mixed with other drugs,
even with those who sold freely, as certain anticatarrales drugs. Take a stimulant in
excessive amounts can lead a person to develop a dangerously high body
temperature or irregular heart rhythm. Take several high doses of stimulants during
a short period of time can make the person to become aggressive or paranoid.
Although the stimulant abuse does not usually cause physical dependence or
withdrawal, sensations that these substances cause in people who consume them
can lead them to use them more and more frequently, becoming a habit difficult
to abandon their consumption.
The dangers of abusing prescription medicines can be even worse if people take
these drugs in a different way from which it should be used. The Ritalín may seem
harmless because it prescribed even young children with ADHD. But if a person
takes it unnecessarily or incorrectly, snorting it, or injecting it, the toxicity of the
Ritalín can be very severeSome problems of the abuse of drugs
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The abuse of pain relievers
The pain is only a symptom and abusing
painkillers, masking the manifestation of the
Agency with respect to any underlying disease.
While it is reasonable to look for a paleativo
effect, we must not forget that although the
symptom has assigned, the problem that
generates the pain has not disappeared.
Abuse of antibiotics
Especially when they are consumed orally and
through prolonged administrations, destroy not only
the germs that you want to remove, but also the
intestinal flora which can cause damage the
immune system of the colon.
Abuse of laxatives
Prolonged use of laxatives leads to addiction and
just hampers evacuation in a natural way. The use
of laxatives should be limited to an occasional
remedy.
And since there are many varieties of a same
medicine, the dose of the medicinal product and
the time that remains in the body may vary. If a
person does not have prescription, may not know
what specific drug you are taking.
Probably, the most common result of the abuse of prescription drugs
addiction. Abusers of drugs may become addicts with as easily as those
who consume illicit drugs. Why the many medications must be prescribed
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by a doctor is that some of them are addictive. Why most doctors not
renew prescriptions, unless they can see the patient: want to look at it to
make sure that it is not developing addiction.
6.-Case Report
Self-Medication of Migraine Headaches with Freebase Cocaine
Introduction
Cocaine is a commonly abused drug with a
high potential for adverse consequences.
Although the etiology of cocaine
dependence is complex, the self-medication
hypothesis asserts that certain persons initiate
cocaine use in order to medicate themselves
for an underlying psychiatric disorder
(Khantzian, 1985). This hypothesis is supported
in part by diagnostic studies which suggest a
high prevalence of psychopathology in
cocaine abusers (Gawin & Kleber, 1986;
Weiss, Mirin, Michael, & Sollogub, 1986).
Additional support is provided by a number of case reports which describe
patients who apparently used cocaine to self-medicate either affective disorders
or attention deficit disorder. In most of these case reports, specific
pharmacotherapy for the psychiatric disorder resulted in dramatic improvement in
the cocaine dependence.
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History and background
The patient was a 29 year old man who
began having headaches at age 23. The
headache was described as a throbbing
pain over the right temple that lasted
between four hours and four days.
Headaches were preceded by blurred
vision, flashing purple and clear lights, and
were associated with nausea. They
occurred between one and four times per
month. During a headache, the patient
preferred to lie still in a dark, quiet room until
it subsided. If he took a combination of
ergotamine and caffeine early in the course
of a headache, he sometimes obtained relief.
He avoided taking more than two pills during an episode and so used the
medication suboptimally. Previous trials with propanolol and amitriptyline were
unsuccessful in treating his migraines.
He first tried smoking freebase cocaine at age 27 at the urging of a friend who
suggested that it might help a headache he had at the time. Indeed, he noticed
immediate and complete relief lasting between five and fifteen minutes, after
which the euphoric peak subsided and his headache returned. He found that he
could sustain relief with each additional “hit off the pipe” for another five to fifteen
minutes, after which the headache returned again.
He repeated this pattern for the next three headaches he had. After his fourth
episode of smoking cocaine, he began to use cocaine even when he did not
have a headache. The cocaine never brought on a migraine headache if he did
not already have one at the beginning of use.
Gradually, his use of cocaine escalated until he was consuming between 10 to 14
grams every two weeks at a cost of $1000.
Typically, he experienced little or no craving between paydays; but as soon as he
had his paycheck in hand, he felt an intense desire to obtain and use cocaine.
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Within the, one month prior to admission, the patient lost his job and marriage due
to cocaine use.
Treatment
The patient was treated on a specialized inpatient ward for substance abuse. The
treatment consisted of individual and group therapy that was supplemented by
drug education. An ergotamine preparation was prescribed for the headaches,
and instructions were given for optimal use. During the 28 days of inpatient
treatment, the patient remained free of cocaine and experienced only one
headache, which was mild and responded to four hours of bedrest. Following the
inpatient program, he was discharged to a half-way house for recovering
substance abusers.
Discussion
More importantly, the case illustrates cocaine use which apparently began as a
self-treatment for headaches and culminated in a full-blown cocaine
dependence.
When planning the treatment strategy for the patient, it was helpful to consider:
The factors that initiated cocaine use
The factors that perpetuated addictive use.
An examination of the phenomenology of cocaine dependence suggests that the
factors involved in perpetuating addictive use may be quite distinct from those
involved in initiating use. The lives of patients dependent on cocaine become
increasingly organized around thinking about, obtaining, using, and recovering
from the effects of the drug. Their relationship with the chemical eventually
supersedes prior relationships with other people and activities. In this patient, for
example, compulsive use continued despite adverse consequences such as
marital, job, and financial losses. Initially, however, when self-medication was his
motive, he was able to terminate his cocaine use when the migraine symptoms
subsided.
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Other patients who are purely self-medicating their psychiatric symptoms should
manifest a similar pattern of controlled use. By contrast, his addictive use was
related to new symptoms, such as craving, which occurred in the absence of
migraines.
Dependent cocaine users often report profound euphoria with immediate use
alternating with equally profound dysphoria, craving, and other withdrawal
symptoms when the acute effects subside.
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